Module 2B (Ch. 39, 21, 41, 38) Flashcards
A child is brought to the clinic after falling from a swing and scraping both
knees and hands. An examination reveals abraded skin with oozing serous fluid and blood, along with dirt and grime from the playground surface. What will the primary care pediatric nurse practitioner do to minimize the risk of infection
Irrigate gently with normal saline
A schoolage child steps on a nail while wearing tennis shoes and develops
cellulitis in that foot. The child’s immunizations are uptodate. What antibiotic will the pediatric
nurse practitioner empirically prescribe
Ciprofloxacin
A child has a 1cm laceration on the forehead proximal to the hairline after
running into a pole while playing sports. To minimize the risk of infection, the primary care
pediatric nurse practitioner will irrigate the wound and
suture the wound within 6 hours.
The primary care pediatric nurse practitioner is preparing to close a
laceration on a child’s forehead using topical skin adhesive. What is the correct way to apply this product
Hold the wound edges together and apply the adhesive on top of the skin.
A toddler is brought to the clinic after grabbing the hot end of his mother’s curling iron. An examination reveals a pale, yellow burned area to the palm of one hand. What is true about this burn
It may take up to 3 weeks to heal with scarring likely.
A schoolage child sustained a contusion on the front of one thigh while
playing football and reports some difficulty flexing his foot on the affected side. What will the primary care pediatric nurse practitioner do to treat this injury?
Refer the child to an orthopedic specialist for immediate evaluation and treatment.
child is bitten on one arm by a neighbor’s dog. The dog is immunized
against rabies and the child’s last tetanus immunization was 4 years prior. The wound edges are gaping and avulsed. What is an important initial intervention when treating this injury?
Irrigation of the wounds with highpressure normal saline
A child is brought to the clinic immediately after being stung by a wasp while
playing in the yard. The physical examination reveals localized redness and edema at the site, along with abdominal tenderness, watery eyes, and generalized hives. What is the initial treatment?
Administer intramuscular epinephrine.
A child is bitten by a snake near a swimming pool in an area where copperhead snakes are known to inhabit, although the parents cannot describe the snake. An examination of the bite reveals a severe local reaction at the site with edema and intense pain. What will the primary care pediatric nurse practitioner do first?
Transport the child by ambulance to a medical center
The primary care pediatric nurse practitioner uses a shared decisionmaking
(SDM) model when working with families of children with chronic health conditions. When using this
model, the nurse practitioner can expect
improved patient health outcomes.
The primary care pediatric nurse practitioner diagnoses a 5yearold child with
asthma and prescribes an oral steroid and a shortacting betaadrenergic medication via a metereddose inhaler to manage acute symptoms. Along with education about the prescribed medications, what information is important to give the child’s family at this visit?
Effects and side effects of current medications
The parent of a child with complex health care needs tells the primary care
pediatric nurse practitioner that the child has had difficulty breathing the past two nights but can’t articulate specific symptoms. The child has normal oxygen saturations and a normal respiratory rate with clear breath sounds. What will the nurse practitioner do?
Encourage the parent to call when concerned and schedule a followup appointment the next day.
Which characteristic is the key criterion that identifies a child has having special
needs?
Health service requirements
The primary care pediatric nurse practitioner is performing a well baby
examination on a 2weekold infant who was recently discharged home from the neonatal intensive care unit. The mother reports that the infant was born at 26 weeks’ gestation and states she was told that her baby will probably have developmental delays. What is the most important aspect of longterm management for this infant?
Careful monitoring of attainment of developmental milestones
The primary care pediatric nurse practitioner is preparing to perform a well child
examination on a 5yearold child who has multiple developmental and cognitive delays. The child’s mother is angry and tells the nurse practitioner that her friends’ children are all preparing for kindergarten. The nurse practitioner will
allow the mother to express her feelings, understanding that she is experiencing grief
The parent of a toddler who has special health care needs is resistant to a
suggestion that her child needs a gastrostomy tube for nutrition. The toddler has fallen from the 10th percentile to the 5th percentile in the past few months and resists taking in appropriate amounts of food by mouth even with assistance from occupational therapy. What will the primary care pediatric nurse practitioner do
Set weight gain and food intake goals with the mother and schedule regular visits to monitor weight.
What is the most important role of the primary care pediatric nurse practitioner
who provides care for a child with special health care needs who sees several specialists and receives community and schoolbased services?
Coordinating services to ensure continuity of care
A toddler swallowed a coin several days prior. The child’s parent has not found
the coin in the child’s stool. Which imaging test will the primary care pediatric nurse practitioner
employ to evaluate this ingestion?
Conventional radiograph
The primary care pediatric nurse practitioner is assessing an ill 2monthold infant
who is febrile and refusing most fluids. The preliminary blood work indicates a viral infection and shows that the infant is hydrated. The infant is alert. The infant’s parents are attentive and live close by. What will the nurse practitioner do?
Give the parents sick care instructions and follow up in the clinic in the morning.
A toddler is prescribed a liquid oral medication. The parent tells the primary care pediatric nurse practitioner that the child refuses to take medications and usually spits them out. What will the nurse practitioner do?
Demonstrate oral medication administration with the toddler in the office.
The primary care pediatric nurse practitioner orders a pulmonology consult for a
child who has severe asthma. The nurse practitioner writes “child with asthma refractory to conventional treatments needs suggestions for alternative treatments.” The nurse practitioner expects the pulmonologist to
make recommendations for disease management.
The primary care pediatric nurse practitioner cares for several families with
chronically ill children who text status updates about their children to a mobile device that has an encryption protection platform installed. If the nurse practitioner misplaces the mobile device, it is important to
disconnect the user from the system to avoid a data breach.
The parent of an 18monthold child calls the clinic to report that the child has a
rectal temperature of 100.4°F (38°C). The child is playing normally, taking fluids well, and has a slightly reduced appetite. What will the primary care pediatric nurse practitioner recommend?
Offering extra fluids and calling if symptoms change
The parent of a preschoolage child calls the clinic to report that the child has
clear, watery drainage from both eyes, mild erythema of the conjunctiva, and no fever or other
symptoms. What will the primary care pediatric nurse practitioner recommend
Allow the child to go to preschool
A parent brings a 4monthold infant to the clinic who has had a lowgrade fever
for 24 hours. The primary care nurse practitioner notes that the infant has a weak cry, slightly dry oral mucosa, mottled skin, and a respiratory rate of 65 breaths per minute and sleeps unless stimulated by the examiner,. What will the nurse practitioner do?
Admit the infant to the hospital.
What is true about haploid cells?
Each one contains 23 chromosomes.
What does the following genetic notation symbol mean 47,XX,6q?
Female with deletion on the long arm of chromosome 6
A child has a recessive genetic disorder that is homozygous for that mutation.
What is most likely about this child’s parents?
Each parent has one copy of that gene mutation
Which type of mutation is responsible for many singlegene genetic disorders
Monogenetic
The primary care pediatric nurse practitioner is counseling a couple about genetic
risks and learns that one parent has neurofibromatosis, an autosomal dominant disorder, and the other parent does not. What will the nurse practitioner include when discussing this disorder and its transmission
Each child born to this couple will have a 50% risk of having the disease.
A family medical history conducted during a well baby exam for a newborn girl
reveals that hemophilia A, an Xlinked recessive disorder, is present in males in three previous generations in the mother’s family, whose father had the disease. What will the primary care pediatric nurse practitioner tell the parents about the risk of this disease in their children
Daughters have a 50% chance of being carriers of the disease.
What is an important responsibility of the primary care pediatric nurse practitioner to help determine genetic risk factors in families
Obtaining a threegeneration pedigree for each family
Which diagnostic study may be ordered when the provider wishes to detect the presence of additional genetic material on a chromosome?
FISH
Which type of testing will the primary care pediatric nurse practitioner recommend ID: 13348407640 for a couple concerned about the potential for having children with cystic fibrosis?
Carrier testing
A schoolage child has a fractured wrist with a SalterHarris Type II fracture, according to the radiologist. What is true about this type of fracture
There is a metaphyseal fragment on the compression side of fracture
What will the primary care pediatric nurse practitioner elicit when obtaining a
positive Barlow maneuver when screening for developmental dysplasia of the hip?
Dislocation of an unstable hip
A 3yearold child is brought to the clinic by a parent who reports that the
child refuses to use the right arm after being swung by both arms while playing. The child is sitting with the right arm held slightly flexed and close to the body. There is no swelling or ecchymosis present. What will the primary care pediatric nurse practitioner do?
Gently attempt a supination and flexion technique.
A schoolage child falls off a swing and suffers a closed fracture of the right clavicle. How will this be managed
Immobilization with a sling to support the affected extremity
A young adolescent reports chest pain associated with coughing and lifting.
Physical examination reveals tenderness over several ribs, radiating to the back. Auscultation of the heart, lungs, and abdomen are normal. There is no history of injury. What will the primary care pediatric nurse practitioner do?
Recommend NSAIDs, stretching exercises, and ice packs to the area.
A young adolescent female is observed to have mild unequal scapula
prominences on gross examination while standing. In the Adams forward bending position, this inequality disappears. What will the primary care pediatric nurse practitioner do?
Discuss posture and exercise and ask about backpacks and books.
The primary care pediatric nurse practitioner elicits positive Ortolani and
Barlow signs in a 6monthold infant not previously noted in the medical record. What is the
correct treatment
Surgical intervention
A 14yearold boy who is overweight develops a unilateral limp with pain in
the hip and knee on the affected side. An exam reveals external rotation of the hip when flexed and pain associated with attempts to internally rotate the hip. What is most important initially when managing this child’s condition
Place the child on crutches or in a wheelchair to prevent weightbearing.
A parent is concerned that a 12monthold child is “bowlegged.” A physical
examination reveals internal tibial torsion bilaterally. A radiograph reveals asymmetric bowing of the legs with an angle greater than 15 degrees. What is the correct action for the primary care pediatric nurse practitioner
Refer to a pediatric orthopedic specialist for treatment.
A child who plays soccer is in the clinic reporting pain and swelling in both
knees. A physical examination reveals swelling and focal tenderness at the tibial tuberosities, with pain worsening when asked to extend the knees against resistance. What is the treatment for this condition
Apply ice packs to both knees and avoid activities that cause pain.
During a well baby examination of a newborn, the primary care pediatric
nurse practitioner notes adduction of the right forefoot, with normal position of the mid and hindfoot, along with a convexshaped lateral border of the foot. What will the nurse practitioner do to evaluate this deformity?
Grasp the heel with one hand and abduct the forefoot with the other hand
